Long-acting testosterone treatment improves health-related quality of life in men with low testosterone levels compared with a placebo

This well designed study investigated the benefit of treatment with long-acting testosterone in 120 Malaysian men who had low levels of testosterone (also known as hypogonadism) and poor health-related quality of life. Participants received either intramuscular injections of long-acting testosterone or placebo (sham) injections at regular intervals over a year. Their health-related quality of life was assessed using a questionnaire designed to measure the severity of symptoms and changes in symptom severity over time (the so-called “Aging Male Symptoms” rating scale). Men included in the study were aged between 40 and 70 years and had at least mild symptoms according to the rating scale as well as a low testosterone level at the start of the study.

Key Findings

Testosterone levels returned to normal in the men who received testosterone treatment (intramuscular testosterone undecanoate) but not in men who received placebo injections (as expected)

The health-related quality of life of treated men improved significantly more than that of men receiving the placebo treatment (see figure)

The greatest improvements, compared with placebo, were seen in physical and psychological symptoms, although sexual symptoms also improved.

Background information

Low testosterone levels are common in older men and are associated with a range of physical, psychological and sexual symptoms. Testosterone replacement treatment (TRT) has been shown to improve symptoms and the health-related quality of life in these men. The Aging Male Symptoms scale is a tool for measuring quality of life in hypogonadal men and studies have shown that the output of the scale can match testosterone levels, and can identify hypogonadism and measure how well treatment is working.
The improvements in quality of life that came about as a result of testosterone treatment in this study are similar to those seen in other studies including Asian and European men.